Many injured people wonder why they are being referred for a psychological evaluation. Many respond "I'm injured, not crazy. This is not in my head!" Although you may not have been aware of this before, psychologists play an important role in working with injured persons for a number of reasons. Some of these are as follows:
1. Most people find having a serious illness or injury to be very stressful. If you are having much pain or stress, other problems can arise. This can include getting grouchy with your family or having difficulty sleeping.
2. If you are in the work comp system/personal injury system, many people find that just being in this system can be stressful. Having less money coming in can be very difficult, and you may have less control in this system than you do with your own family doctor.
3. Many people find themselves facing major life decisions following the onset of a serious illness or injury. Will you be able to return to your old job? Will you need to go back to school? Facing the possibility of having to find a new and different job can be the cause of a lot of worrying.
4. Some psychological conditions can lead to physical symptoms. It is important to know if this is the case, so that you can get the correct treatment. In other cases, stress, depression or other psychological diffculties can make recovery from an illness or injury more difficult.
5. Some of the medications which are prescribed for pain conditions are potentially addicting. This needs to be watched carefully so that another problem isn't created.
6. Some of the treatments for pain conditions were developed by psychologists. For example, one of these treatments, Biofeedback, has been endorsed as being effective by the US Food and Drug Administration. It is commonly used, and is especially useful for persons who do not wish to take medication.
Another reason for psychological evaluations is that it is an accepted part of general clinical practice. For example, the 1995 Treatment Guidelines produced by the Colorado Division of Worker's Compensation state that there should be a psychological component to work hardening programs, functional restoration programs, and chronic pain programs. With regard to back pain cases, these regulations go on to state that:
Personality/psychological/psychosocial evaluations are generally accepted and well established diagnostic procedures with selected use in the acute back pain population, but have more widespread use in the subacute and chronic back pain population. These procedures may be useful for patients with delayed recovery, chronic pain, recurrent painful conditions, suspected concomitant closed head injury, disability problems and preoperative evaluation, as well as a possible predictive value for postoperative response.
Overall, psychological evaluations are a part of "holistic" treatment, where the whole person is treated, not just the injured part. Sometimes factors outside the injury itself can have a bearing on whether or not you are able to get better and return to work. Our job is to assess how you are doing now, to report our finding to your Doctor and your insurer, and to make whatever recommendations we can.
If you have any further question about this, please ask your doctor.
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